BURA Collection: HERG's strategic focus is on the economic evaluation of a broad range of clinical and health service technologies and its dual aim is to provide applied, policy-relevant research whilst developing and refining methods to increase the rigour and relevance of such studies.

ESIC Series: Paper 9 Estimating initial costs of Evidence Synthesis Infrastructure Collaborative solutions: assumptions and overall results

Mon, 21 Sep 2026 00:00:00 GMT

Title: ESIC Series: Paper 9 Estimating initial costs of Evidence Synthesis Infrastructure Collaborative solutions: assumptions and overall results Authors: Pokhrel, Subhash; Hanney, Stephen Abstract: Aim: To estimate the initial costs of implementing the Evidence Synthesis Infrastructure Collaborative (ESIC) solutions and therefore provide funders with a costed menu of options for strengthening global evidence synthesis systems. Background: ESIC was established to enhance the timeliness, relevance, and affordability of evidence synthesis worldwide. Five Working Groups and a Governance Planning Group were tasked with identifying priority solutions to address systemic gaps in infrastructure, capacity, and governance. We were tasked with costing these solutions from a funder’s perspective to inform strategic investment decisions. Methods: We followed a structured approach with planning of the costing occurring concurrently with the solutions being identified by the groups. We identified resource requirements, measured quantities, and applied unit costs. Inputs included personnel, tools, and system requirements, with indirect costs set at 20% of direct costs and an additional 5% for monitoring, evaluation, and learning. Data were gathered through resource-use questionnaires, literature reviews, and consultations with ESIC groups. Salary costs were estimated using a 3×3 matrix of seniority and geographic bands (Global North; Global South—high/upper-middle income; Global South—low/lower-middle income). Sensitivity analyses addressed uncertainties, particularly in salary assumptions. A separate costing exercise was conducted for a Vanguard Suite, a prioritised collection of 100 living evidence syntheses. Results: The total estimated cost for all 40 solutions identified by the groups was US$278.3 million (range: US$257.2–299 million). Employment costs accounted for the largest share, with 80% of staff time and 78% of senior roles allocated to the Global South, reflecting ESIC’s equity goals. Individual group costs ranged from US$9.1 million (Governance) to US$70.5 million (Data solutions). The suite of living evidence syntheses was costed at US$19.2 million. Conclusion This costing exercise provides transparent, equity-focused information to assist funders when selecting scalable solutions aligned with ESIC’s mission. While estimates involve assumptions, they offer a pragmatic basis for investment planning and demonstrate ESIC’s commitment to affordability, inclusivity, and global impact.

Assessing and optimizing research and innovation impact: developing and implementing a holistic systems approach

Thu, 08 Jan 2026 00:00:00 GMT

Title: Assessing and optimizing research and innovation impact: developing and implementing a holistic systems approach Authors: Graham, Kathryn ER; John, Reesa; Botwe, Augustine; Chan, Liza; Grant, Jonathan C; Hanney, Stephen R Abstract: Increasing demand to demonstrate the societal impact of research and innovation investments comes not only from government and funders for accountability purposes, but also private industry and others, who want to use impact evaluation to inform ways of increasing benefits, and improve their return on investment. Citizens also wish to see an increase in benefits to their region. Impact assessments should also further the understanding of “what works or does not work, under what conditions for whom”. In Alberta, Canada, we developed a “fit for purpose” performance and impact management system that aims to assess impact and optimize returns for decision makers while engaging users. This paper describes the Alberta team’s work that evolved from applying an evidence-based practice framework for evaluating research impact. Drawing on various theories, methodological developments resulted from testing models and approaches across sectors for generating practice-based evidence. The paper outlines the evolution across six phases that contribute to the international literature, and highlights the development of applications, resulting in new learnings and reflections with each iteration. Key learnings are that designing for impact upfront, and continuously monitoring and evaluating impact are effective tools to inform adjustments along implementation pathways to enhance impact. Transitioning to a holistic systems approach that values quantitative and qualitative methods, and combines evidence from impact management systems is necessary for assessing challenge type initiatives. A promising practice is conducting complementary deep-dive realist impact assessment case studies to help understand “how” and “why” the impact occurred and who benefited. Description: Supplementary data are available at: https://academic.oup.com/rev/article/doi/10.1093/reseval/rvag011/8522956?login=false#supplementary-data .

Health research versus the virus: strengthening systems, saving lives

Fri, 25 Jul 2025 00:00:00 GMT

Title: Health research versus the virus: strengthening systems, saving lives Authors: Hanney, Stephen Robert; Yazdizadeh, Bahareh Abstract: For this Commentary, we selected papers from those in this journal’s Thematic Series on health research systems’ pandemic response. The calling notice for papers suggested possible use of a WHO framework for analysing health research systems (HRSs). Whilst it was not widely used in the reported studies, it did provide the basis for the two main, overlapping, topics for analysis in this Commentary. These, in turn, informed the selection criteria for papers. First, we selected papers that described the contributions made towards meeting the needs for pandemic-related research in at least one area we could classify as being one of the nine components of a HRS, and did so in at least one jurisdiction. Second, we identified papers that could contribute to an analysis of how comprehensive HRSs facilitated progress in meeting the needs for pandemic-related research. Using the selection criteria, we included 13 papers in the Commentary covering research in 22 named countries, and many others unnamed. For the first topic, we found that for each of the nine components, we could identify at least two of the included papers, usually more, as having in some ways analysed the contributions made towards meeting the needs for pandemic-related research. Examples included, for coordination, the first HRS component, a paper describing a pandemic preparedness program in Australia. For other HRS components, some papers analysed prioritization systems in the United Kingdom and Iran, and another, research ethics governance across Central American countries. For the finance component, a US paper covered Operation Warp Speed’s substantial funding. Papers showed existing capacity for conducting trials contributed to rapid progress on new drugs and vaccines in Brazil, the United Kingdom and the United States. Included papers showed how capacity was mobilized for knowledge production and how evidence, often locally produced, was used in many countries across the income range. Papers cited studies showing pandemic research had saved millions of lives through vaccines and repurposed drugs. For the second topic, evidence suggested that where there was a comprehensive HRS, especially with an overall strategy, considerable progress was made. The Commentary’s added value lies in it extracting, collating and organizing data from the 13 papers to facilitate analysis of HRSs. Collectively, the papers provide evidence about the benefits of strengthening HRSs, and challenges (including resource waste) when HRSs were not well developed. This can justify a recommendation to give serious consideration to WHO’s call in 2013 for a comprehensive approach to developing health research systems as fully as possible, in as many countries as possible. This could be particularly important before any future pandemics. Description: Availability of data and materials: All data and material can be found in the cited publications.

Characteristics of private health insurance enrollees and the association between health coverage type and outpatient service utilization in Saudi Arabia: Insights from the National Saudi Family Health Survey

Thu, 30 Apr 2026 00:00:00 GMT

Title: Characteristics of private health insurance enrollees and the association between health coverage type and outpatient service utilization in Saudi Arabia: Insights from the National Saudi Family Health Survey Authors: Althabaiti, KS; Hunsberger, M; Khan, J; Ahmed, S Abstract: The Kingdom of Saudi Arabia (KSA) has a mixed health financing system consisting of governmental health coverage (GHC) and private health insurance (PHI). In 2016, KSA launched Vision 2030, which aims to reduce government spending and increase reliance on employer-sponsored PHI. This reform may affect the utilization of health services based on citizenship and the type of health coverage (PHI compared with GHC). The current study aimed to identify the characteristics of private health insurance enrollees and the association between different types of health coverage (GHC and PHI) and outpatient service utilization in the KSA. This study used data from the 2018 Saudi Family Health Survey (SFHS), which included 8,276 respondents aged 18 years and above and collected information on outpatient utilization during the previous 12 months. Statistical analyses were conducted using SPSS version 26. Bivariate analyses (chi-square and t-tests) were used to assess differences by nationality and coverage type. Binary logistic regression was used to examine the characteristics of PHI enrollment, and Poisson regression was used to evaluate the association between coverage type and outpatient utilization. This dataset provides a pre-reform baseline for assessing PHI enrollment and outpatient utilization prior to the implementation of the first phase of the reform in 2019. Most respondents were Saudi nationals (76.8%), and 54.9% were male. About 26.2% of respondents had PHI. Among non-Saudis, 72.8% were enrolled in PHI, compared with only 12.1% of Saudis. The logistic regression analysis revealed that having PHI was associated with factors such as a high monthly income, non-Saudi, male, being married, a high level of education, and a perception of good health. We found that having PHI was negatively associated with the utilization of outpatient services (coefficient −0.107; P < 0.001) compared with GHC. This finding may reflect barriers to access, a lower perceived need, or limitations in awareness of PHI benefits. In addition, this finding suggests that PHI may be associated with disparities in healthcare access, based on the observed lower utilization of outpatient services among its enrollees compared with those covered by GHC. Other factors associated with the utilization of outpatient services were being female, having a high monthly income, being never married, having chronic diseases, and the perception of poor health. The results of this study may inform future health reform efforts to enhance access to healthcare. These findings should be considered when planning the implementation and evaluation of the health system in KSA. Description: Data Availability: The data underlying the findings of this study are from the Saudi Family Health Survey (SFHS) and are owned by the General Authority for Statistics (GASTAT), Saudi Arabia. The dataset cannot be shared publicly, deposited in a public repository, or provided as supplementary material due to legal and ethical restrictions imposed by the data owner and the terms of access approval. Access to the data requires a formal request to GASTAT specifying the study objectives and the required variables. Researchers may request access by contacting GASTAT at cs@stats.gov.sa. The authors do not have the legal right to publicly share or redistribute the dataset.